Los Angeles County-Run Hospitals Show Improved Performance

Los Angeles County Department of Health Services (DHS) hospitals rate average and above average in several key quality indicators and showed improvement in other areas according to the latest quarterly report card from the California Hospital Assessment and Reporting Taskforce (CHART), released recently.

The CHART project was established in 2004 by a group of hospitals, purchasers and health plans to provide consumers with comparative hospital data to make more informed health care choices, and more than 200 California public and private hospitals currently participate in this voluntary effort.

Los Angeles County was a founding member of the CHART initiative and supports efforts to continually improve quality and the patient experience in our system, said DHS Director and Chief Medical Officer Bruce Chernof, MD. CHART is an important mechanism to examine areas of performance strength and weakness.

The aggregated data includes core measures routinely provided and made available publicly on the Joint Commission website combined with mortality data from the Office of Statewide Health Planning & Development (OSHPD) and patient satisfaction data. Additional measures are expected in the future.

The report ranks performance on a 1-5 scale in areas such as heart attack care, heart failure care, pneumonia care, infection prevention, and coronary artery bypass and pneumonia mortality. Of the 16 counties in California’s public hospital system, Los Angeles County is one of seven participating in this project.

AMI (heart attack care), pneumonia, heart failure and other measures include several components. Some components measure clinical practice, such as administering aspirin or other medications upon arrival or at discharge, other components measure preventative practices such as smoking cessation counseling and providing discharge instructions. Scores may be affected by poor performance in either the clinical practice or the prevention component. Overall, DHS Hospitals score at or above the state and national averages for clinical components and there are opportunities to improve performance in the preventative components.

Olive View-UCLA Medical Center rated a score of 1, or superior and LAC+USC Medical Center rated a score of 2 or above average for the AMI, or heart attack care composite. For the Pneumonia Quality measure, Harbor-UCLA and Olive View-UCLA Medical Centers maintained their ratings of average.

Several initiatives have been implemented to improve ratings at each hospital. For example, nurse training to screen patients for vaccination eligibility and the creation of new clinical pathways to facilitate more effective patient management were implemented.

The most recent round of data covers different time periods. For heart attack care, pneumonia care, heart failure care and surgical infection prevention, the data measures performance between April, 2006 and March, 2007. Other data measures hospital performance from 2002 to 2004.

A breakdown of the time periods for each of the data elements is available on the CHART website and scores are based on data collected over a year’s time. Consequently, improvements in one quarter may not be immediately reflected in the data score. In some categories there is not enough data to make an analysis.

Consumers can access the CHART website at www.calhospitalcompare.org